Case #507

New DRG in MDC12 for outpatient stereotactic radiotherapy or demanding isotope therapy cases

Added by Kristiina Kahur almost 5 years ago. Updated almost 4 years ago.

Status:AcceptedStart date:2017-01-17
Priority:NormalSpent time:-
Assignee:Kristiina Kahur
Category:-
Target version:Expert Group 2017
Initiator:Finland Target year:2018
MDC:MDC12 Owner / responsible:National organisations
Target Grouper:FIN Old forum status:

Description

Problem
DRG 912A Male reproductive system tumor, radiotherapy, short therapy in Finnish grouper is meant for cases of male reproductive tumor treated with radiotherapy. It includes four different groups of procedures: radiotherapy (PROCPROP 90T05), radiotherapy with large shaped fields (90T06), stereotactic radiotherapy or demanding isotope therapy (90T07), special demanding isotope therapy (90T08).
The number of cases in 912A is high (ca 27 000 in 2014 and ca 31 000 in 2015), so is the variation coefficient, 182% and 201% respectively. That was the indication for further analysis.

Analysis
The mean cost of DRG 912A is 175 EUR in 2014 and 193 in 2015 ranging between 30 and 5 820 EUR, and 30 and 14 889 EUR respectively.
The cases with PROCPROP 90T07 differ from the rest of the group and have the mean cost ca ten times higher compared to the DRG 912A average, i.e. 193 EUR vs ca 1 800 EUR in 2015.
Also the variation coefficient of cases with PROCPROP 90T07 is much lower than all cases in DRG 912A (34% versus 201% in 2015) and shows the cost homogeneity of selected cases.

Suggestion
Based on the cost analysis we suggest create separate DRG for outpatient cases with PROCPROP 90T07.

DRG change
The cases with main diagnosis from MDC12 and procedure code with PROCPRO 90T07 will be grouped in a new DRG 912C.
Name of the new DRG should be Male reproductive system tumor, stereotactic radiotherapy or demanding isotope therapy, short therapy.

Technical changes
Appendix 2. The technical changes may contain mistakes and have to be used with caution.

Cost analysis
Appendix 1. Cost analysis is based on five university hospital data of 2015, grouped with Finnish 2017 grouper, and data of 2014, grouped with Finnish 2016 grouper.

MDC12_912A_St.tactic rad.therapy_short_therapy_Appendix1.xlsx - Appendix 1 (12.9 KB) Kristiina Kahur, 2017-01-17 16:12

MDC12_912A_St.tactic rad.therapy_short_therapy_Appendix2.xlsx - Appendix 2 (15.2 KB) Kristiina Kahur, 2017-01-17 16:12

Case 507_Norwegian DRG solution.xlsx (14.8 KB) Kristin Dahlen, 2017-03-06 15:25

Technical changes case #507.xlsx (17.7 KB) Martti Virtanen, 2017-04-26 17:12

History

#1 Updated by Kristin Dahlen over 4 years ago

In Norway we have already implemented a split for this cases.
DRG 852N Brachyterapy for prostate cancer (covers both inpatient and outpatient cases) and DRG 852X Brachyterapy for tumor, outpatient.
This DRGs are part of a logic concerning both the radiotherapy and the planning of radiotherapy.
See the enclosed excel sheet for the Norwegian DRG logic.

#2 Updated by Martti Virtanen over 4 years ago

2107-03-13 Expert group.
The change was accepted for Finland. Nowegian or other versions are not changed.

#3 Updated by Martti Virtanen over 4 years ago

2017-04-26 Martti Virtanen
Technical changes for combined NordDRG version.
Changes affect only NordDRG Fin.
The new rule needs to be place before ther rules for DRG 912A

#4 Updated by Martti Virtanen almost 4 years ago

  • Status changed from Active to Accepted

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